Surgical outcome for type I Guyon's canal syndrome with claw hand deformity: a review of 11 patients.

Abstract

Guyon's canal syndrome (GCS) is an uncommon compressive ulnar neuropathy at the wrist, and claw hand deformity could be seen in severe Tpye I cases. Data on whether claw hand deformity could be reversed by surgical treatment is lacking, and we aimed to evaluate the prognosis of these patients. 11 patients with claw hand deformity were enrolled in this retrospective study, and the minimum follow-up was set at 1 year. All patients underwent exploration of the ulnar nerve, decompression of Guyon's canal, and removal of potentially concomitant space-occupying lesions. Clinical symptoms, physical examination findings, and the Disabilities of the Shoulder, Arm, and Hand Questionnaire were evaluated preoperatively and at final follow-up. Motor strength of intrinsic muscles was rated using the British Medical Research Council (MRC) scale. VAS pain and weakness, 2-PD, and key-pinch strength all improved significantly. Improvement of intrinsic muscle strength was achieved in all 11 hands, and 8 hands (72.7%) regained MRC grade 5 muscle strength. Claw hand deformity was completely corrected in 10 patients (90.9%) at final follow-up. DASH scores improved from an average of 30.1 points preoperatively to 3.7 points postoperatively. Surgical outcome for Tpye I GCS with claw hand deformity is satisfactory, and claw hand deformity could be reversed with promising functional recovery of intrinsic muscles.